TY - JOUR
T1 - Transcatheter arterial chemoembolization therapy for patients with hepatocellular carcinoma: a case-controlled study
AU - Camma', Calogero
AU - Andreone, Pietro
AU - Gasbarrini, Giovanni
AU - Gramenzi, Annagiulia
AU - Rosellini, Salvatore Ricca
AU - Lorenzini, Stefania
AU - Biselli, Maurizio
AU - Cursaro, Carmela
AU - Trevisani, Franco
AU - Bernardi, Mauro
AU - Rossi, Cristina
AU - Stefanini, Giuseppe Francesco
AU - Cammà, Carlo
PY - 2005
Y1 - 2005
N2 - Background & Aims: Transcatheter arterial chemoembolization (TACE) currently is used as a palliative treatment for patients with unresectable hepatocellular carcinoma (HCC), but its efficacy still is debated. Our aim was to assess the impact of TACE on patient survival and to identify prognostic factors for survival. Methods: Fifty-six cirrhotic patients with unresectable HCC undergoing at least :1 course of TACE were matched 1:1. for sex, age (in 5-year periods), parameters of Child-Pugh score, Okuda stage, and tumor type with a control group who had received only supportive care. Results: The 2 groups were comparable for cause of cirrhosis, alpha-fetoprotein serum levels, and Cancer of the Liver Italian Program (CLIP) score. The 56 patients in the TACE group received a total of 123 treatment courses. The median follow-up period was 16 months (range, 1-67 mo) in the TACE group and 5 months (range, 1-77 mo) in the supportive care group. Survival rates at 12, 24, and 30 months in patients receiving TACE were 74.3%, 52.1%, and 38.8% respectively, with a median survival time of 25 month whereas in supportive care patients the rates we 39.4%, 25.4%, and 19%, respectively, with a median survival time of 7 months (P =.0004). At univariate analysis, TACE, tumor type, presence of ascites, alpha-fetoprotein serum level, CLIP score, and Okuda stage were associated significantly with survival. Only TACE and CLIP score proved to be independent predictors of survival at multivariate analysis. Conclusions: TACE is an effective therapeutic option for cirrhotic patients with unresectable HCC and a CLIP score of 3 or less.
AB - Background & Aims: Transcatheter arterial chemoembolization (TACE) currently is used as a palliative treatment for patients with unresectable hepatocellular carcinoma (HCC), but its efficacy still is debated. Our aim was to assess the impact of TACE on patient survival and to identify prognostic factors for survival. Methods: Fifty-six cirrhotic patients with unresectable HCC undergoing at least :1 course of TACE were matched 1:1. for sex, age (in 5-year periods), parameters of Child-Pugh score, Okuda stage, and tumor type with a control group who had received only supportive care. Results: The 2 groups were comparable for cause of cirrhosis, alpha-fetoprotein serum levels, and Cancer of the Liver Italian Program (CLIP) score. The 56 patients in the TACE group received a total of 123 treatment courses. The median follow-up period was 16 months (range, 1-67 mo) in the TACE group and 5 months (range, 1-77 mo) in the supportive care group. Survival rates at 12, 24, and 30 months in patients receiving TACE were 74.3%, 52.1%, and 38.8% respectively, with a median survival time of 25 month whereas in supportive care patients the rates we 39.4%, 25.4%, and 19%, respectively, with a median survival time of 7 months (P =.0004). At univariate analysis, TACE, tumor type, presence of ascites, alpha-fetoprotein serum level, CLIP score, and Okuda stage were associated significantly with survival. Only TACE and CLIP score proved to be independent predictors of survival at multivariate analysis. Conclusions: TACE is an effective therapeutic option for cirrhotic patients with unresectable HCC and a CLIP score of 3 or less.
KW - Cirrhosis
KW - Lipiodol chemoembolization
KW - Liver-Transplantation
KW - Multivariate-analysis
KW - Oily chemoembolization
KW - Prognostic system
KW - Randomized controlled trial
KW - Survival
KW - Transarterial chemoembolization
KW - Validation
KW - Cirrhosis
KW - Lipiodol chemoembolization
KW - Liver-Transplantation
KW - Multivariate-analysis
KW - Oily chemoembolization
KW - Prognostic system
KW - Randomized controlled trial
KW - Survival
KW - Transarterial chemoembolization
KW - Validation
UR - http://hdl.handle.net/10447/34319
M3 - Article
VL - 3
SP - 918
EP - 925
JO - Clinical Gastroenterology and Hepatology
JF - Clinical Gastroenterology and Hepatology
SN - 1542-3565
ER -